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From Dave’s Desk: Clinical variation and care coordination

As I discussed in my blog post about outmigration, cutting costs is a huge challenge for the healthcare industry. The two main ways that any business can cut costs are by eliminating waste and reducing variation in business processes. In this blog post, I’ll discuss the importance of reducing clinical variation in the healthcare industry.

The cost of variation

I believe that the costly impact of waste on the business side of the healthcare industry is in part due to the amount of variation in the clinical practices that healthcare systems use.

For example, if five different physicians in a hospital system treat the same disease in five different ways, then the system needs to have five different treatment approaches that each include a different set of processes, supplies, therapies, and drugs. Using five approaches is wasteful in many ways if only one approach could be used successfully most of the time. More products must be purchased and managed (and are at risk of expiring), and multiple techniques and protocols must be taught to new clinicians. And those are just a couple of examples of the types of waste that are created by using five different approaches. In this manner, variation in clinical practices creates waste throughout entire healthcare systems in all kinds of ways.

Care coordination and clinical pathways

To help manage costs and improve patient care, many hospital systems are addressing the problem of variation by prioritizing care coordination: the collaboration of a clinical team (physicians, nurses, managers, etc.) in order to create more deliberate and effective healthcare protocols.

Many healthcare systems have created roles within their systems that are dedicated to evaluating healthcare practices from a business and clinical outcomes standpoint. The individuals in those roles work with clinicians to help clinicians understand how costly variation is to their healthcare system. And then together they work to discover variation. When clinicians participate in this discovery process, they can help create a clinical pathway, a set of procedures or processes that are used to generate an expected outcome for a particular group of patients who have the same diagnosis or who present with the same set of symptoms.

Optimizing healthcare treatments

Care coordination and the use of clinical pathways represent a shift in the healthcare industry—a shift from the art of practicing medicine to the science of practicing medicine. Clinical pathways put boundaries around treatment protocols so that clinicians ensure that they take all of the necessary measures to provide the best possible outcome but also avoid taking excessive treatment measures that are unnecessary and won’t help the patient.

Of course, the art of medicine should still be employed in the right circumstances, in specific cases, but using clinical pathways allows clinicians to better identify the exceptional cases and, for the rest of us, use the treatment that was proven to yield the best results for the average patient. Over time, as healthcare systems gather data about their clinical pathways, processes, and protocols, they can refine their treatment protocols and provide patients with better outcomes and more confidence in their treatment.

Your thoughts

How are you working to reduce variation in your healthcare system? Share your thoughts with me on Twitter and LinkedIn.

David Reed is currently Vice President of Operations, Vice President of Healthcare Business Solutions for Cook Medical Incorporated. With over 30 years of life science industry expertise Dave holds an MBA from California Miramar University and serves as a member of the Indiana University Kelly School of Business Supply Chain and Global Management Academy Advisory Board.